Comparing in vivo kinematics of unicondylar and bi-unicondylar knee replacements
Comparing in vivo kinematics of unicondylar and bi-unicondylar knee replacements
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DOI：
10.1007/s00167-004-0565-x
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发表时间：
2005-10-01
影响因子：
3.8
通讯作者：
Romagnoli, S
中科院分区：
文献类型：
--
作者：
Banks, SA;Fregly, BJ;Romagnoli, S
在单髁膝关节置换术中保留两个交叉韧带可能提供更正常的膝关节力学，并有助于增强患者功能。因此，与牺牲一个或两个交叉韧带的关节置换术相比，全膝关节置换术保留两个交叉韧带应提供功能受益。本研究的目的是比较功能最佳的保留交叉韧带的内侧单髁和双单髁关节置换术患者的膝关节运动学，以确定膝关节活动是否存在差异。在跑步机步态、爬楼梯和最大屈曲活动期间，使用侧位荧光镜对8名同意接受7例内侧单髁和5例双单髁关节置换术的患者进行了研究。基于CT和CAD数据的患者特定几何模型用于形状匹配，以确定三维膝关节运动学。计算了置换间室的胫股接触位置。单髁膝关节的最大屈膝度为135 ° ± 14 °，双单髁膝关节的最大屈膝度为123 ° ± 14 °（p= 0.22）。在楼梯活动过程中，对于0 °- 30 °屈曲，单髁膝关节内侧髁向后平移3.5 ± 2.5 mm，双单髁膝关节内侧髁向后平移4.7 ± 1.9 mm（p> 0.05）。双单髁膝关节在0 °-30 °屈曲时的外侧后平移为5.0 +/- 2.3 mm。从脚跟着地到站立中期，胫骨几乎没有旋转，但单髁膝关节显示内侧髁后移1.5 ± 1.6 mm，而双单髁膝关节显示内侧髁后移5.1 ± 2.2 mm（P
Preserving both cruciate ligaments in unicondylar knee arthroplasty likely provides more normal knee mechanics and contributes to enhanced patient function. It follows that preserving both cruciate ligaments with total knee arthroplasty should provide functional benefit compared to arthroplasty sacrificing one or both cruciates. The purpose of this study was to compare knee kinematics in patients with optimally functioning cruciate-preserving medial unicondylar and bi-unicondylar arthroplasty to determine if knee motions differed. Eight consenting patients with seven medial unicondylar and five bi-unicondylar arthroplasties were studied using lateral fluoroscopy during treadmill gait, stair stepping, and maximum flexion activities. Patient-specific geometric models based on CT and CAD data were used for shape matching to determine the three-dimensional knee kinematics. Tibiofemoral contact locations were computed for the replaced compartments. Maximum flexion in kneeling was 135 degrees +/- 14 degrees for unicondylar knees and 123 degrees +/- 14 degrees for bi-unicondylar knees (p= 0.22). For 0 degrees - 30 degrees flexion during the stair activity, the medial condyle translated posterior 3.5 +/- 2.5 mm in unicondylar knees and 4.7 +/- 1.9 mm in bi-unicondylar knees ( p> 0.05). Lateral posterior translation was 5.0 +/- 2.3 mm in bi-unicondylar knees for 0 degrees - 30 degrees flexion. From heel-strike to mid-stance phase, there was little tibial rotation, but unicondylar knees showed 1.5 +/- 1.6 mm posterior translation of the medial condyle, while bi-unicondylar knees showed 5.1 +/- 2.2 mm ( p